The effect of location, strategy, and operations technology on hospital performance

Abstract

Hospitals in the US are faced with challenges in how to compete and remain viable in an increasingly competitive environment. Using data from a primary survey of hospitals and from various secondary sources, we investigate the incremental effects on hospital performance of location, strategy, and technology. We find that hospital location is significantly related to performance, but that a hospital’s choice of strategy can moderate the effect of location. Additionally, we find hospitals that invest more extensively in clinical technologies tend to be better performers regardless of location. Hospital size, measured as number of beds, captures the effects of location and technology investment in accounting for a major portion of hospital performance. While we cannot argue that larger is always better for hospitals, mergers, partnerships, and other forms of consolidation currently observed in the marketplace indicate that managers in the hospital industry understand the advantage of size.

Examining the joint effects of strategic priorities, use of management control systems, and personal background on hospital performance

“…Empirical research in management and accounting notes the implications of strategic orientation for managerial practices (e.g., Chenhall and Langfield-Smith, 1998;Ittner et al, 2003;Mintzberg, 1990;Porter, 1980) Previous literature also offers healthcare-specific strategic frameworks (e.g., Goldstein et al, 2002;Nath and Sudharshan, 1994;Wells and Banaszak-Holl, 2000). Zelman and Parham (1990) characterise four strategies hospitals use to define their business focus (i.e., generalist, market specialist, service specialist, or super specialist).…”

“…This strategic priority focuses on ensuring the hospital's internal operational activities, such as patient care, research and education, and meeting safety and quality requirements, which reflect an important long-term priority for hospitals (Brown et al, 2005;Goldstein et al, 2002;Nath and Sudharshan, 1994;Young et al, 1992). This priority involves the ongoing effort to improve valuable, high quality services that meet or exceed patient expectations (Carman et al, 2010).…”

Práticas de gestão em hospitais privados de médio porte em São Paulo, Brasil

“…Conforme esperado, os maiores têm um melhor nível de gestão. A relação com o porte foi encontrada em estudos anteriores nos Estados Unidos e no Brasil 49,50,51 . O mais amplo uso de práticas também está associado a um desempenho superior, pelo menos em termos de taxa de utilização.…”

Development of foreign invested hospitals in China: obstacles and coping strategies

“…Given that location has an effect on hospital performance [17] and size has an impact on hospital development [12] , we selected hospitals with varying sizes from four different locations to reduce selection biases. To choose the hospitals representative of the issue of interest, an expert panel consisting three professors from Beijing University and China Pharmaceutical University was consulted.…”